13-103481 • • Electrical
F City of Federal Way
Services - Permit #: 13-103481 -00-EL
� �Federal Way,WA 98003 1`1[Commun3ity338,25Ec87.ADveevs.
(253)835-2607 Fax (253)835-2609 ;:> Inspection Request Line: (253) 835-3050
Project Name: DAVITA- OUTDOOR DINING TERRACE
Project Address: 32275 32ND AVE S Parcel Number: 215465 0080
Project Description: Electrical work for dining terrace addition.
Owner Applicant Contractor
DAVITA PRIME ELECTRIC INC PRIME ELECTRIC INC
1423 PACIFIC AVE 13301 SE 26TH ST PRIMEEI134BT(1/30/15)
TACOMA WA 98402 BELLEVUE WA 98005 13301 SE 26TH ST
BELLEVUE WA 98005
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Alt.Srvc/Feeder 0 to 200 amps(C 1
PERMIT EXPIRES Sunday, February 2, 2014
Permit Issued on Tuesday, August 6, 2013
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be_ ordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: ! Date: �'
FINALED
THIS CARD IS TO MAIN ON-SITE
•
v Construction In ection Record - •
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 13-103481-00-EL Address: 32275 32ND AVE S
Project: DAVITA FEDERAL WAY, WA 98003
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
❑ UFER Ground (4295) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) El Temporary Power(4275) ❑ Service (4235)
Approved Approved Approved
By Date By Date By Date
.0 Feeders/Sub-panels(4045) ElRough Electrical(4225) ElCeiling Cover(4020) '
Approved Approved Approved
By Date By Date By Date
,
ID Final-Electrical(4055)
Approved
By ` 7 Date /i/ 7/f />
❑ Rough ElectricalCI Final Electrical Right of Way
Approved Approved Approved .
By Date By Date By Date
tECEIVED
RECEIVED
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F1ELECTRICAL
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CITY OFA U U O I LU 1�
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
CITY OF ORAL WAY
/PERMIT NUMBER / - 0 3 Ce $ / - 0 v
3SUITE/UNIT/SPACE#
SITE ADDRESS: 312-7C ? Z N° IA-U tC N t c E- S ou TN
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ . , S`v0 Z I 5 `f (o S - O O O
PROJECT NAME
(Tenant or Homeowner Last Name) 04- lit T-A,
Pr�,,l �� ELe-%'e-'t.4c /'...J i<•L 2 -rtes .4 C' r4-,A 0•i7o4J
PROJECT DESCRIPTION /Ai e`" 4,Af4444,,h3 cc_4-0e- 444,4?7AAI , S •¢ u� i,�
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Detailed description of work to /1-6.),a..4)4 /l)4 /"e,,v ea. 1 /4,11—Ze4 d0A)N Fc 7704/5.
be included on this permit only
NAME , / PRIMARY PHONE
•2)
PROPERTY OWNER A V i rpt, (2S3 ) 382- ft ?Z
MAILING ADDRESS E-MAIL
/ `-/z.5 ,t-c-•ix/c. AdeN u L
CITY STATE ZIP FAX
31-C_0.A,.A k)44 9 '"o2 ( ) -
NAME PRIMARY PHONE
P/LI °rlE et CcT2.t ( yzji7Y! - S2cso
MAILING ADDRESS E-MAIL
ELECTRICAL / 33 C./ 55 2G r11 S- se r �L i°"i4 #t:@ Re.,'"A`, Co.M
CONTRACTOR CITYTSTATE ZIP FAX
/Sc.4.cL•e:✓LcE WAt9�'o-s ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PR--t VA_ 4 t 1 3 41 3 T / / 20 • oO -(0 1 7 4,7-60-l34.-..
NAME PRIMARY PHONE
APPLICANT 1,) 4
2-0 � LJ ,u.r3e0 ` At v t. ,L5,..„-Lie r (L/2S) 7ci7- c-2.0 0
MAILING ADDRESS E-MAIL
/3314 se 2-4 ` .S;xc ,— leL4A144'14 0 PA-4MEet-
CITY STATE ZIP FAX - e".
riCeLLEc/u-c4' 4J/' ,toa- ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT 4,7 -r`_-_�- L,' wt 6 4m-t (las-) R.y- 4./2 3 .
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
/'fir.. --- DATE ? /3
SIGNATURE:
PRINT NAME: "'o..✓ ' ' " '' -i
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application